BILL NUMBER: SB 566 AMENDED
BILL TEXT
AMENDED IN SENATE APRIL 7, 1999
INTRODUCED BY Senator Escutia
FEBRUARY 19, 1999
An act to add Chapter 8 (commencing with Section 124950)
to Part 4 of Division 106 of the Health and Safety
amend Section 12693.29 of, and to add Section 12693.265 to, the
Insurance Code, and to add Section 14087.306 to the Welfare and
Institutions Code, relating to school health programs.
LEGISLATIVE COUNSEL'S DIGEST
SB 566, as amended, Escutia. School health programs.
Existing law provides for the Healthy Families Program,
administered by the Major Risk Medical Insurance Board, in order to
arrange for health care coverage for low-income children.
Existing law provides for the Medi-Cal program, administered by
the State Department of Health Services, under which qualified
low-income persons are provided with health care services.
This bill would require, as a condition of contracting under these
programs, that health plans contracting under the Healthy Families
Program and managed care plans contracting under the Medi-Cal program
negotiate contracts with school-based health care programs in their
geographic area that provide primary medical care.
Existing law includes various programs to provide primary health
care services to the people of California. Existing law also
provides health care services and health coverage to families and
children meeting specified requirements, through the Medi-Cal and
Healthy Families programs.
This bill would declare legislative intent to enact legislation
that will enable school districts to develop partnerships with public
or private health care organizations to ensure that students receive
preventative and primary medical treatment in a timely and efficient
manner, including by supporting school programs in increasing the
number of eligible schoolage children enrolled in the Medi-Cal and
Healthy Families programs, and by requiring the Medi-Cal and Healthy
Families managed care programs to include within their provider
networks those school health programs that provide primary medical
care.
Vote: majority. Appropriation: no. Fiscal committee:
no yes . State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Chapter 8 (commencing with Section 124950) is added to
Part 4 of Division 106 of the Health and Safety Code, to read:
CHAPTER 8. SCHOOL HEALTH PROGRAMS
124950. It is the intent of the Legislature to enact legislation
that will enable school districts to develop partnerships with public
or private health care organizations to ensure that students receive
preventative and primary medical treatment in a timely and efficient
manner. It is the intent of the Legislature that this legislation
do all of the following:
(a) Provide support for school programs to increase the number of
eligible schoolage children enrolled in the Medi-Cal program (Chapter
7 (commencing with Section 14000) of Part 3 of Division 9 of the
Welfare and Institutions Code), and the Healthy Families Program
(Part 6.2 (commencing with Section 12693) of Division 2 of the
Insurance Code).
(b) Expand health resources available to students in schools.
(c) Require the Medi-Cal and Healthy Families managed care
programs to include within their provider networks those school
health programs that provide primary medical care. These school
health programs shall be included in a manner, and upon terms and
conditions, that are no less favorable than those that are extended
to any other network primary care provider of pediatric and
adolescent ambulatory care. The State Department of Health Services
shall facilitate the integration of school health programs into these
networks.
(d) Require Medi-Cal and Healthy Families managed care
organizations to provide documentation of the efforts made to include
school health programs as network providers.
SECTION 1. Section 12693.265 is added to the Insurance Code,
immediately after Section 12693.26, to read:
12693.265. (a) The executive director of the board shall require
that, as a condition of contracting with the Healthy Families
Program, or of renewing an existing contract, a participating health
plan negotiate amendment contracts with the school-based health care
programs in its geographic area that provide primary medical care.
(b) Under the terms of a contract between a health plan and a
school-based program, the plan shall reimburse the school-based
health care program for eligible services provided to children
enrolled in the participating plan.
(c) The board shall provide technical assistance to support the
negotiations between participating health plans and school-based
health care programs.
SEC. 2. Section 12693.29 of the Insurance Code is amended to read:
12693.29. (a) The board shall use appropriate and efficient means
to notify families of the availability of health coverage from the
program.
(b) The State Department of Health Services in conjunction with
the board shall conduct a community outreach and education campaign
in accordance with Section 14067 of the Welfare and Institutions Code
to assist in notifying families of the availability of health
coverage for their children. Twenty percent of the moneys
allocated for the community outreach and education campaign shall be
expended for school-based outreach programs conducted by schools.
(c) The board shall use appropriate materials, which may include
brochures, pamphlets, fliers, posters, and other promotional items,
to notify families of the availability of coverage through the
program.
SEC. 3. Section 14087.306 is added to the Welfare and Institutions
Code, to read:
14087.306. (a) The director shall require that, as a condition of
contracting with the department under this chapter or Chapter 8
(commencing with Section 14200), or of renewing an existing contract,
a Medi-Cal managed care plan negotiate contracts with the
school-based health care programs in its geographic area that provide
primary medical care.
(b) Under the terms of a contract between a Medi-Cal managed care
plan and a school-based program, the plan shall reimburse the
school-based health care program for eligible services provided to
children enrolled in the plan.
(c) The department shall provide technical assistance to support
the negotiations between Medi-Cal managed care plans and school-based
health care programs.